2855 Geer Rd, Turlock, CA 95382 • (209) 668-9361 • (209) 668-0539

Creative Alternatives STRTP Preparedness Plan- Coronavirus (COVID-19)

By:  Brandi Boehme, STRTP Program Director

Date: March 20, 2020

Creative Alternatives’ Short-Term Residential Therapeutic Program has developed modified business practices to adhere to state and federal government recommendations relating to the Coronavirus. These measures seek to prevent spread of the virus among staff, clients, and communities. The leadership team has evaluated how this pandemic is most likely to affect our agency and has a well devised plan for specific areas where the program will be most impacted.  The agency released posting materials to the facilities as early as 2/28/20 to alert employees to the Coronavirus and provided education on prevention measures. Leadership continues to monitor the evolving situation closely and will continue to communicate all intent to modify business operations to necessary regulatory entities. The modifications placed into effect may be reinstated at any time by direction of the agency or at the urging of regulatory departments.

Intake Referrals

Creative Alternatives will not be accepting new clients in the STRTP facilities. The agency will continue  to take measures to maintain ample staffing to serve all existing clients in our care during the everchanging coronavirus orders by state and federal government. In order to do so, we will need to minimize the number of clients served in our STRTP facilities to allow for employee absenteeism and staffing needs due to school closure.  This will prevent the agency from accepting any new STRTP clients at this time. 

This plan will remain in effect pending state and federal order updates. We will continue to re-evaluate the agency’s ability to serve new clients throughout and hope to remove this measure as soon as possible. In the meantime, the intake referral e-mail for Raul Mata will not be responding to inquiries for placement.  We will continue to provide the best care possible to existing clients and are eager to resume accepting new clients once things stabilize.

Trainings and Meetings

In accordance with federal and state recommendations, the agency has assessed the non-essential gatherings that are scheduled to occur and have cancelled all until further notice.

Although Creative Alternatives will not host or attend Child and Family Team Meetings in person, participation of clients and staff will continue by teleconferencing. This may be done via another agency’s teleconferencing resource or by one of the resources supported by the Creative Alternatives Informational Technology Department. Among those available are GoToMeeting, Facetime, Skype, and Discord. 

A guide for use will be issued by the Creative Alternative Informational Technology team soon.  Any Creative Alternatives employee may contact an IT team member by e-mail to inquire about the best available option for their scenario.

Travel and Visitation

“Shelter in place” orders for at least 6 counties were issued beginning 3/16/20. This prompted Creative Alternatives to suspend travel to and not allow visitors from outlying counties effective 3/17/20.  Governor Newsom later issued a state-wide “stay at home order” on 3/19/20. Additionally, both Merced and Stanislaus courts have issued orders preventing face-to-face visitation locally effective 3/19/20. All in-person visitations are suspended at this time.

As a substitute to the prohibited in-person visits, the agency will identify a videoconferencing alternative that works for each family. Creative Alternatives Informational Technology Department had developed an instructional support guide for staff and may assist with connecting family members with options that work best for their situation.  Among the options available are GoToMeeting, Facetime, Skype, and Discord.

Visitors still allowed to the facilities include: Creative Alternatives personnel, county authorized representatives, Public Health Departments, and regulatory entities such as Community Care Licensing and Department of Health Care Services. 

Client Activities

The state-wide “stay at home order” will restrict most client activities to the facilities; however, outdoor activities are encouraged when at all possible. Outdoor recreation and neighborhood walks will be conducted with the expectation of social distancing.  If clients are unable to adhere to social distancing expectations, they risk being dismissed from the opportunity.

Any unsupervised time privileges granted to clients by their Needs and Services Plan will be suspended for all community activities.  Neighborhood walks with use of social distancing may continue if the client’s team has the ability to do so in accordance with government orders.

The Food Services Director, Asst. Program Director, and Program Director are responsible for the primary shopping for each facility. Facility staff will not need to shop for facility needs. Clients and staff will not participate in store runs, as it will not be necessary for essential needs. Clients and staff may utilize drive-thru community resources at the request of the client.

Facility staff are working towards identifying activities that most appeal to their specific client population to fill the hours associated with school closure.  Multiple activities will be offered, in addition to supporting in-house education specific to each client’s plan.

Psychiatric Services & Psychotropic Medications

Dr. John Yarbrough will continue to provide medication support services to clients at the previously scheduled locations. The agency has the capability of videoconferencing should it become necessary at a later time.

The agency will continue to work with GKN Pharmacy to ensure access to medication refills and new prescriptions. Due to the closure of the Merced and Turlock offices, plans to receive and deliver medications may be altered by coordination between GKN and Creative Alternatives nurses.

Personnel

Direct service staff will continue to report to their assigned STRTP facilities.  Those in this classification include: Counselor I/II staff, Asst. Facility Supervisors, and Facility Supervisors.  Clinicians, Heads of Service, and Mental Health Workers will provide direct services, but may utilize teleconferencing options.

The agency is appropriately staffed at this time, but anticipates a high number of employee absences throughout this process. In order to create a realistic plan, we are asking that all employees evaluate their current status, understand the entitlements available to them, and express their intent to continue working or utilize available entitlements. As an agency, we must brace ourselves for employee absenteeism and determine how realistic our staffing numbers will be to serve the clients in our care. We understand that an employee may not fully know their needs at this time.  We are making efforts to prevent a sudden, unexpected drop of employees that would make it very challenging to cover supervision and leave working employees feeling overloaded. 

Hiring

We have confirmed that multiple livescan offices are closed, but have confirmed that Gaurdco in Merced is continuing operations.  A limited number of livescan opportunities may restrict an efficient flow of onboarding new employees.  Regular recruitment efforts will be hindered for persons not previously scanned elsewhere. We will continue to focus our efforts of known school employees within our agency and from local school districts that can prove employment. Due to school closures, proof of employment may be difficult, also impacting the ability to backfill losses. We will continue to manage this to the best of our ability and will keep our licensing office informed of modifications to the hiring plan.

Diagnosed Clients or Staff

It is impossible to capture exactly how the agency will respond, as any exposure would require a case specific plan. It will be medical professionals and the local Public Health Departments that will determine isolation procedures appropriate for the case, not at the choosing of Creative Alternatives. We would then follow recommendations of the medical staff and/ or the Public Health Department, as necessary. We are working to develop a list of employees willing to work with any client that may test positive to the Coronavirus or be ordered to home isolation.

The agency is hopeful that the local Public Health Department and/ or medical professionals responsible will factor in the residential living situation if a client becomes ill, but must be prepared for the possibility of home isolation. We currently have two empty facilities ready to isolate a client(s) outside of their normal residential setting and are seeking individuals who are willing to divert from their primary facility to assist with serving clients in the isolation facility. Additional protective equipment would be provided and capacity would remain lowered to control person to person distancing. Further planning for this possibility is still being coordinated.

Food & Cleaning Supply

We have two well stocked warehouses with food/cleaning supplies, which allows our agency to be better prepared for supply and distribution issues that could arise. The agency’s Food Service Director is responsible for coordinating ordering and distribution to facilities. The agency has contracts with Sysco and Central Sanitary Supply. The current stock of materials on hand equates to two months of food and cleaning supplies for all operating facilities.

STRTP personnel will continue to pick up necessary items from these warehouses twice weekly. The agency will have the capacity to accommodate home deliveries should it become necessary.

Office Personnel and Business Hours

The Turlock and Merced offices will remain closed, allowing periodic attendance to essential Human Resource, Informational Technology, Accounting personnel, and other staff to maintain the business needs of our essential programs. Various employees will work from home when possible and will report to work to manage pay, employee files, etc. that cannot be done via telework.

The offices are closed to the public until further notice. Incoming calls to the main lines will be transferred to off-site personnel for assistance or routing. Additionally, the office work extensions will be transferred to the cell phones of key personnel for immediate transfer. A list of those employee extensions will be available separately. Those that can be reached by extension transfers are Executive Director, Asst. Executive Director, STRTP Program Director, Asst. Program Directors, agency Social Workers, HR Director, HR Generalist, Accounting Director, Mental Health Program Director, Clinical Supervisor, and Manager of Organizational Development.

All facility mail is received by the Turlock and Merced offices. Facility mail will be managed by restricted office personnel contacting facilities periodically to coordinate pickups.  

Employee Travel

All employees requiring continued service to the agency will be supplied with a signed letter. This letter will provide law enforcement with the traveler’s order of business needing travel exception and offers the Executive Director’s phone number for any questions. Staff are expected to have their employee badge during travel to associate them with the agency.

Workplace Practices

The STRTP facilities have the unique responsibility of assuring workplace practices to prevent spread, while functioning as a household for the clients served. We ask that staff members continue to protect their families, our clients, and one another by following all of the precautionary measures outlined by the Center for Disease Control (CDC). Among the recommendations for reducing risk within households are:

  •     Clean hands at the door and at regular intervals
  •     Create habits and reminders to avoid touching their face and cover coughs and sneezes 
  •     Disinfect surfaces like doorknobs, tables, and handrails regularly
  •     Increase ventilation by opening windows or adjusting air conditioning 

All individuals entering the facilities are expected to wash their hands immediately. Staff will continue to promote person to person distancing where allowable within the space limitations of a household. TV trays and fold-up table/ chairs are available for each facility to provide greater distances during meal/ snack times when necessary.

Employees should report concerns of improper practices to Facility Supervisors for handling.

Communication With Authorized Representatives

Information updates are available on the Creative Alternatives website for anyone seeking details. The agency Social Workers are responsible for forwarding updates regarding modification to business practices and client specific information to the authorized representative by e-mail. They will continue to be the responsible party for coordinating client needs and maintaining reporting requirements to the placing agents. Due to telework status of our agency Social Workers in relation to the Coronavirus, signatures on required documentation will be unattainable for the duration of telework practices. Reports such as Needs and Services Plans and the 30-Day Reviews will be absent of signatures from clients and authorized representatives in the client record, but will not prevent the client from receiving services. _______________________________________________________________________

Modifications to policy and practices will continue to be necessary as information evolves with great frequency.  We appreciate the cooperation of our staff, regulatory entities, and community partners as we navigate through these uncharted waters together. The agency will inform necessary parties as quickly as possible when changes occur.